Morning lectures

Most residency programs have some sort of lecture series built in to the program, in order the satisfy ACGME regulations. In my first year of residency, we had two hours of lecture weekly at 7AM.

For PM&R residents, especially at my program, 7AM was really early. I mean, it was prohibitively early. Nobody seemed able to make it to lecture that early and the residents whined constantly about it. The response of the program director was to threaten us. One of the first emails I ever got from the PD was saying that we’d be put on probation if we missed or were late for too many lectures (and welcome to residency!).

The next year, the lectures were moved to 7:30AM. This was still too early. Finally, in my last year, they were moved to 8AM. Still, this was kind of early, especially for the PGY4s.

These lectures somehow seemed to bring out the worst in everyone. The residents would whine about them being too early, not useful, and complain about the threats of extra call or probation for no shows or latecomers. Moreover, the residents would take their sweet time getting back to work after the lecture. Yes, we all worked at different locations, but none of them were more than 30 minutes away from each other, much less TWO HOURS.

At the same time, the attendings and administrators didn’t show their best side either. Instead of scaling back their clinics during those mornings, a lot of attendings canceled their clinics altogether. I mean, is an attending really incapable of seeing a few patients alone one morning per week? Really? And the inpatient wards were a mess. Some attendings had to be yelled at by the chairman because they would refuse to see any patients or do absolutely any work until their resident showed up for the day, leaving the resident to do a day’s worth of work in half a day.

And the threats were unpleasant as well. The most popular threat was that we’d get extra call if we were late. One particularly stringent chief resident informed us that there was absolutely no excuse for being late. He said if we were in a car accident that morning, we would still be marked down as being late or absent.

Me: “You’re joking, right? You’d penalize someone if they were late because of a car accident?”

Chief: “What’s the difference? It’s just one extra call.”

Of course, they were idle threats. I don’t think anyone ever got extra call over being late; otherwise, the senior residents would have done the majority of call during that year.